title: Comparative epidemiological study of non-melanoma skin cancer between Spanish and north and central European residents on the Costa del Sol.
abstract: BACKGROUND
  Non-melanoma skin cancer (NMSC) is the most common tumour in white people. The progressive increase of these malignancies in such populations as those found in Europe represents an important public health concern which it is presumed will have a great impact on healthcare costs. However, the lack of comparable epidemiological information between countries hinders the development of a common health policy.
  
  
  OBJECTIVE
  The aim of this study was to describe the epidemiological, clinical and therapeutic aspects of NMSC in the public health area of the western part of the Costa del Sol, in southern Spain, and study the differences between the Spanish (S) population and that originally between the north and centre of Europe (N).
  
  
  METHODS
  We undertook a retrospective analysis of all patients with histologically confirmed tumours in both populations during the period 1 January 2006 to 30 June 2009.
  
  
  RESULTS
  In comparison with the Spanish, the patients from the north and centre of Europe were more likely to have phototype I/II (S: 56.9%; N: 85.8%), recreational photoexposure (S: 48.4%; N: 83.8%), multiple carcinomas (S: 16.8%; N: 28.2%) and more carcinomas per patient (S: 1.7 ± 1.3; N: 2.3 ± 2.3). The tumours were more often located on the trunk and limbs (S: 28.3%; N: 50.2%) with a predominance of the less aggressive histological types (S: 34.7%; N: 42.6%) and non-invasive treatments in patients from the north and centre of Europe (S: 25.6%; N: 35.3%) when compared with the Spanish population.
  
  
  CONCLUSIONS
  Persons from the north and centre of Europe living on the Costa del Sol present a different pattern of NMSC to the local Spanish population and usually require a less invasive therapeutic approach. These findings highlight the need to define prevention and treatment policies for NMSC according to the characteristics of each particular population. This would help reduce not only the frequency but also the associated morbimortality of this disease, particularly in high-risk populations.
authors.affiliation: Department of Dermatology Research support Unit, Hospital Costa del Sol, Marbella, Spain. miagbe@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Aguilar Bernier
authors.forename: F
authors.initials: F
authors.lastname: Rivas Ruiz
authors.forename: M
authors.initials: M
authors.lastname: De Troya Martín
authors.forename: N
authors.initials: N
authors.lastname: Blázquez Sánchez
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000453:epidemiology*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000453:epidemiology*; D013030:Spain / Q000453:epidemiology